Overview of the debate
Germany’s sick leave levels have become a heated political topic after Chancellor Friedrich Merz sharply criticized the countrywide rate of sickness absence, calling the average of 14.5 sick days per employee too high and questioning whether it is really necessary. He also urged the end of the telephone sick note that has been allowed since 2021, arguing it could encourage misuse. The debate has brought doctors, insurers and politicians into public disagreement about causes, consequences and possible policy changes around sick leave, telephone sick notes, and access to medical certificates.
Key figures in the discussion
| Measure | Figure cited |
|---|---|
| Average sick days per employee (as criticized) | 14.5 days |
| Reported average sick days in 2024 (insurer data) | 14.8 days |
| Estimated avoidable doctor visits if telephone sick note and early certificates change | 27 million visits per year (claimed figure) |
Support from the doctors’ association
The head of the national association of panel doctors, Andreas Gassen of the Kassenärztliche Bundesvereinigung, publicly supported Chancellor Merz’s critique. He agreed that Germany’s sick leave rate is high in international comparison and criticized the telephone sick note as unreliable. He argued that a reliable medical assessment of work ability cannot be made by telephone and called for the telephone sick note to be abolished. He also proposed removing the obligation to present a medical certificate within the first three days of illness, saying this would prevent millions of unnecessary visits to doctors for minor ailments.
- Abolish the telephone sick note because clinical assessment by phone is unreliable.
- End the requirement to provide a medical certificate during the first three days of sickness to cut unnecessary doctor visits.
- Reduce avoidable consultations for minor respiratory and other brief illnesses, thereby easing pressure on practices.
Criticism and opposing political views
Several political figures and parties have pushed back against the call to abolish the telephone sick note and the framing of the issue as primarily misuse by patients. Critics argue that removing the phone option could make access harder for patients and overload practices, and that broader social and economic factors must be considered when discussing sick leave and absenteeism.
- Concern that ending telephone sick notes would overload doctor offices.
- Calls for more preventive health measures, including screenings and targeted public health policies.
- Reminders that childcare, staffing shortages and working conditions contribute to sick leave levels.
Health minister and prevention-focused response
The health minister rejected the idea that the government’s role should be framed as strict control of patients, calling the approach demeaning. He warned that abolishing the telephone sick note would further crowd medical practices and instead urged a focus on prevention measures such as earlier medical screening programs and stronger tobacco control as ways to reduce illness and long-term absenteeism.
Other political reactions and context
Other politicians pointed to social and structural causes of sickness absence: the need for better childcare and support for working families, chronic overwork and staff shortages in many sectors, and longer-term economic policy shortcomings that influence health and working conditions. These voices emphasize that simple administrative changes to sick note rules may not address root causes of high sickness absence.
Insurance perspective and data interpretation
Major health insurers dispute the claim that telephone sick notes are systematically misused. Insurers point out that rising reported sickness figures can result from better electronic reporting systems and fluctuations in respiratory illness seasons. One insurer noted that the figure for average sick days in 2024 was 14.8, which helps explain observed increases but does not necessarily indicate deliberate abuse of telephone certificates.
| Viewpoint | Explanation |
|---|---|
| Doctors’ association | Telephone certificates are unreliable, encourage unnecessary doctor visits, and should be ended alongside early certificate requirements. |
| Insurers | There is no evidence of widespread systematic misuse; higher numbers reflect improved electronic recording and patterns of respiratory disease. |
Implications and possible next steps
The debate highlights a tension between preventing potential misuse of sick leave and preserving accessible care for patients. Any policy change, such as abolishing the telephone sick note or changing certificate timing rules, would need to weigh effects on patient access, practice workloads and public health. Many experts and politicians argue that improvements in prevention, workplace conditions and health services capacity should be central to reducing sick leave sustainably, while others focus on tightening rules to curb perceived excess absenteeism. The conversation is likely to continue as stakeholders review data, practical impacts on practices and the broader social drivers of sickness absence.
